Tissue shavers

ABSTRACT

Various arthroscopic shavers are provided that minimize contact between bodily fluid and the shaver hand piece. Arthroscopic shavers generally include a cutting assembly mated to a hand piece. In one embodiment, the shaver includes a hub that connects the cutting assembly with the hand piece and has an exit port configured to transport cut tissue and fluid from the device. In another embodiment, the shaver includes a hub configured to retrofit existing shaver hand pieces having interior lumens for removing cut tissue and fluid. The hub further includes an exit port that diverts fluid away from the hand piece.

CROSS-REFERENCE TO RELATED APPLICATIONS

The present application is a continuation of U.S. application Ser. No.13/223,821, filed Sep. 1, 2011, entitled “Tissue Shavers”, thedisclosure of which is incorporated herein by reference in its entirety.

FIELD

The present invention relates to endoscopic shavers for cutting andremoving tissue from the body and methods of using the same.

BACKGROUND

Arthroscopy is a minimally invasive technique for removing diseased ordamaged tissue from intra-articular regions of the body, such as theshoulder, hip, wrist, knee, and spine. Arthroscopic shavers can be usedto remove bone, cartilage, and other soft tissue from a patient's jointwith less surgical trauma to the joint than conventional surgicaltechniques. Typically, an arthroscopic shaver is an electro-mechanicaldevice that includes a hand piece and a cutting assembly. The cuttingassembly often has an elongate, rotatable member for cutting tissue andremoving tissue and fluid from a surgical site. The shaver hand pieceusually has an integrated aspiration/suction port for transferringtissue and fluid through the hand piece and to a waste collectioncontainer. The hand piece can be releasably mated to the cuttingassembly so that the cutting assembly can be disposed of after each use.

During an arthroscopic procedure, the cutting assembly of the shaver isinserted into a small incision. Suction is applied to a suction portthat extends through the handle, causing bodily tissue and associatedfluids to flow through the cutting assembly and out through a proximalend of the hand piece. After the procedure is completed, the shaverblade is typically disposed of while the hand piece is sent to aprocessing center for cleaning and sterilization. Because fluid andtissue can become lodged inside of the hand piece, the hand piece mustbe thoroughly cleaned after each use through an aggressive series ofbrushing operations and/or using automated washing machines. Althoughthe brushing is necessary to remove biological material from the handpiece, it can decrease the durability of the mechanical components anddamage the seals within the shaver hand piece. There is also evidencethat these conventional cleaning techniques are ineffective at removingbiological material. The United States Food and Drug Administration hasinvestigated the cleaning of the shaver hand pieces and found numerouscases where tissue has remained in the shavers after cleaning,compromising the sterility of a surgical site.

Accordingly, there remains a need for a tissue shaver that is easier toclean and that has a decreased risk of contaminating a surgical site.

SUMMARY

The present invention provides various embodiments of arthroscopicshavers. In one embodiment, a cutting assembly for use with a shaverhand piece is provided that includes an outer shaft having an outercutting tip formed on a distal end thereof and an inner shaft rotatablydisposed within the outer shaft and configured to coupled to a driver.The inner shaft can include an inner tissue cutting tip formed on itsdistal end. The cutting assembly can further include a hub coupled tothe inner and outer shafts and configured to releasably mate with ahandle assembly having a driver disposed therein. The hub can also beconfigured to prevent fluid from coming into contact with a handleassembly when the hub is coupled to a handle assembly. Thus, tissue cutby the outer and inner cutting tips can flow through the inner shaftwithout ever contacting the handle assembly.

The cutting assembly can have a variety of features. For example, thecutting assembly can further include an exit port configured to allowfluid and tissue to pass therethrough and being positioned to preventfluid and tissue from flowing out through a proximal end of the cuttingassembly. The hub can further include a driver mating feature forreleasably coupling to a driver disposed in a handle assembly, and ahandle mating feature for releasably coupling to a handle assembly. Incertain aspects, the inner shaft can include at least one portconfigured to allow fluid and tissue to pass therethrough. The exit portof the cutting assembly can also be positioned distal of the drivermating feature formed on a proximal end of the inner hub, and can have acentral axis that extends transverse to a central axis of the inner andouter shafts. The distal end of the hub can be mated to a proximal endof the inner shaft. The hub can also be configured to mate to a driversuch that the driver is effective to rotate the inner shaft relative tothe outer shaft.

In another embodiment, an arthroscopic tissue shaver can include ahandle having a driver, a shaft assembly, and a coupler operablyconnected between the handle and the shaft assembly. The shaft assemblycan include an outer shaft and an inner shaft having at least oneopening formed in their respective distal ends and the inner shaft beingrotatably disposed within the outer shaft. The inner shaft can furtherinclude a tissue cutting distal tip positioned adjacent to the at leastone opening in the outer shaft for cutting tissue exposed through theopening. The coupler can operably connect the handle and the shaftassembly and it can transfer a drive force from the driver to the innershaft. The coupler can also include an exit port for receiving fluidfrom an inner lumen of the inner shaft and it can be configured toprevent passage of the fluid from the inner lumen of the inner shaft tothe handle.

The arthroscopic tissue shaver can have various configurations. Forexample, in one embodiment the coupler includes a proximal end mated tothe driver in the handle, and a distal end mated to a proximal end ofthe inner shaft such that actuation of the driver is effective to rotatethe inner shaft. The coupler can also be removably connected to thehandle and to the shaft assembly. In another embodiment, the shaftassembly and the coupler are integrally formed. The coupler can alsohave an inner lumen formed therein, a first end in communication withthe inner lumen of the inner shaft, and a second end in communicationwith the exit port. In one embodiment, the inner lumen of the couplercan terminate at a location distal of a proximal end of the coupler.

Another embodiment provides a connector for use with a tissue shaver. Inthis embodiment, the connector includes a housing having proximal anddistal ends. The proximal end of the connector can have a drive featurefor coupling to a driver disposed in a handle of the tissue shaver.Similarly, the distal end of the connector can have a drive feature forcoupling to a corresponding drive feature on a proximal end of an innershaft of a tissue shaver. The housing of the connector can furtherinclude a lumen that extends between an entry port formed in the distalend of the housing for receiving fluid from an inner shaft of a tissueshaver, and an exit port formed in a sidewall of the housing at alocation distal to the proximal end of the housing for directing fluidaway from a handle of a tissue shaver. The proximal end of the housingcan also include a first mating feature formed thereon and configured topress-fit with a handle of a tissue shaver, and the distal end of thehousing can include a second mating featured formed thereon andconfigured to press-fit with a shaft assembly of a tissue shaver.

BRIEF DESCRIPTION OF THE DRAWINGS

The invention will be more fully understood from the following detaileddescription taken in conjunction with the accompanying drawings, inwhich:

FIG. 1 is a perspective view of one embodiment of a tissue shaver;

FIG. 2 is a perspective view of a cutting assembly of the tissue shaverof FIG. 1;

FIG. 3 is an exploded perspective view of the cutting assembly of FIG.2;

FIG. 4A is a side view of an outer hub of the cutting assembly of FIG.2, showing an exit port formed therein;

FIG. 4B is a cross-sectional view of the outer hub of FIG. 4A;

FIG. 5A is a perspective view of an inner hub of the cutting assembly ofFIG. 2, showing a mating element configured to mate to the inner shaft;

FIG. 5B is a cross-sectional view of the inner hub of FIG. 5A;

FIG. 5C is an end view of the inner hub of FIGS. 5A and 5B showing amating element configured to mate with a hand piece;

FIG. 6A is a perspective view of the outer hub of FIGS. 4A and 4B matedto the inner hub of FIGS. 5A-5C;

FIG. 6B is a cross-sectional view of the hub assembly shown in FIG. 6A;

FIG. 7A is an exploded perspective view of the inner and outer shafts ofFIG. 3;

FIG. 7B is a perspective view of the inner and outer shafts of FIG. 7Amated to one another;

FIG. 8 is a partially-exploded cross-sectional view of the inner hub ofFIGS. 5A-C mated to the inner shaft of FIG. 3;

FIG. 9 is a cross-sectional view of the outer hub if of FIG. 4A mated tothe outer shaft;

FIG. 10 is a cross-sectional view of the shaft and hub assembly of FIG.2;

FIG. 11 is a perspective view of another embodiment of a tissue shaver;

FIG. 12A is a perspective view of a connector of the tissue shaver ofFIG. 11, showing an exit port formed therein;

FIG. 12B is a perspective view of the connector of FIG. 12A showing amating element configured to mate to a driver disposed in a shaver handpiece;

FIG. 12C is another perspective view of the connector of FIGS. 12A and12B showing a mating feature that can mate to a shaver hand piece and adriver mating element;

FIG. 13 is an exploded view of the connector of FIGS. 12A and 12B; and

FIG. 14 is a cross-sectional view of the connector of FIGS. 12A and 12B.

DETAILED DESCRIPTION

Certain exemplary embodiments will now be described to provide anoverall understanding of the principles of the structure, function,manufacture, and use of the devices and methods disclosed herein. One ormore examples of these embodiments are illustrated in the accompanyingdrawings. Those skilled in the art will understand that the devices andmethods specifically described herein and illustrated in theaccompanying drawings are non-limiting exemplary embodiments and thatthe scope of the present invention is defined solely by the claims. Thefeatures illustrated or described in connection with one exemplaryembodiment may be combined with the features of other embodiments. Suchmodifications and variations are intended to be included within thescope of the present invention.

The present invention generally provides a tissue shaver that isconfigured to minimize contact between tissue/bodily fluid and theshaver hand piece. In general, an arthroscopic shaver is provided forremoving tissue and reshaping a patient's anatomy, and can include ashaft assembly for cutting tissue and a reusable shaver hand piece. Inone embodiment, the shaft assembly has a hub that connects the shaftassembly to the hand piece and that has an exit port for removing tissueand/or fluid from the device. In another embodiment, a connector isprovided that can couple to the shaft assembly. The connector can havean exit port for removing tissue and/or fluid from the device. In anexemplary embodiment, the exit ports of the various embodimentsdisclosed herein are positioned so as to prevent cut tissue and/or fluidfrom coming into contact with the driver and other elements in the handpiece. For example, the hub and the connector, and thus the exit ports,can be positioned distal to the shaver hand piece so that fluid and/ortissue are prevented from flowing into the hand piece, making it easierto sterilize the hand piece after each use.

FIG. 1 illustrates one embodiment of a tissue shaver 10. As shown, thearthroscopic tissue shaver 10 generally includes a hand piece 300 and acutting assembly 100. The hand piece 300 can be configured to be graspedby a user and it can include various drivers and actuators forcontrolling the cutting assembly 100. The cutting assembly 100 can beconfigured to sever and transport tissue away from a surgical site.

While the shaver hand piece 300 can have a variety of configurations, itis preferably configured to facilitate grasping of the device 10 and toallow operation of the device with one hand. In the illustratedembodiment, the hand piece 300 is elongate with a generally cylindricalshape and includes surface features 314 that can provide frictionbetween a user's hand and the hand piece 300. The hand piece 300 canhouse a driver (not shown) that can be operably connected to the cuttingassembly 100 such that engagement of the driver causes the cuttingassembly 100 to sever tissue. The driver can include a drive shaft (notshown) positioned in a central bore of the handle and that can extendtoward a distal end of the hand piece 300 and can mate with a variety ofcutting assemblies known in the art. The driver can further include amotor operably coupled to the drive shaft such that engagement of themotor causes the drive shaft to rotate. The hand piece 300 can beconfigured to connect to an external power source that can supply powerto the motor, for example via socket 316. The hand piece 300 can furtherinclude an actuator, such as one or more buttons 310, for actuating thedriver. The buttons 310 can provide signals to a processor that controlsthe motor and the buttons 310 can have a variety of functions. Forexample, each button 310 can cause the motor to operate in a differentmode, such as a forward mode, reverse mode, or an oscillating mode, orthe buttons 310 can have multiple functions depending upon the speed inwhich a user presses them. The hand piece can also include an actuator,e.g. a rotatable handle 312, for engaging a valve (not shown) thatcontrols the application of suction to the cutting assembly, oralternatively, suction can be applied and controlled using a separatedevice. The hand piece 300 can also integrate with a fluid managementsystem, such as the FMS Duo®+ of DePuy Mitek, Inc. In certain aspects,the hand piece 300 can be configured to be autoclaved without damagingthe functionality of the motor so that the hand piece 300 can besterilized after each use. A person skilled in the art will appreciatethat hand piece can have a variety of configurations and various handpiece assemblies known in the art can be used with the presentinvention.

FIGS. 2 and 3 show the cutting assembly 100 of the arthroscopic shaverof FIG. 1 in more detail. As explained above, the cutting assembly 100is configured to cut and remove tissue from a surgical site. In theillustrated embodiment, the cutting assembly 100 generally includesouter and inner shafts 110, 112 and a hub assembly 130. The outer shaft110 can be mated to an outer cutting element 124 and similarly, theinner shaft 112 can be mated to an inner cutting element 122. The innershaft 112 can be configured to rotate relative to the outer shaft 110 tothereby cut tissue. As shown, the hub assembly 130 can mate the shafts110, 112 to the shaver hand piece 300 and can include an exit port 136for receiving tissue and/or fluid from the shafts 110, 112. A personskilled in the art will appreciate that the cutting assembly can includedifferent components and can have a variety of other configurations forcutting and receiving tissue.

The hub assembly 130 can have various configurations, but in oneembodiment, as shown, the hub assembly 130 includes an outer hub 132 andan inner hub 134. FIGS. 4A-4B show the outer hub 132 in more detail.While the shape of the outer hub 132 can vary, the illustrated hub has agenerally frustoconical shape at a distal end 132 b with areduced-diameter cylindrical portion at a proximal end 132 a. The distalend of the outer hub 132 can be configured to fixedly and non-rotatablymate to the outer shaft 110. Various mating techniques can be used, aswill be discussed in more detail below with respect to the outer shaft110. The proximal end of the outer hub 132 can be configured to mate tothe hand piece 300. Various mating techniques known in the art can beused, such as welding, adhesives, a mechanical engagement, etc. Theouter hub 132 also has a lumen 138 that extends along a central axis Lbetween the proximal and distal ends 132 a, 132 b for transportingtissue and fluid from a surgical site. An exit port 136 can extendbetween the lumen 138 and an outer sidewall of the outer hub 132. Theangle of the exit port 136 relative to the central axis L can vary, e.g.the exit port can extend perpendicular to the axis L, or it can extendat an acute or obtuse angle, as shown. A person skilled in the art willappreciate that the exit port 136 can have a variety of otherconfigurations. The hub assembly can also be formed from a variety ofdifferent materials, including by way of non-limiting example, surgicalgrade stainless steel, titanium, and plastics.

As explained, the hub assembly 130 can also include an inner hub 134that can mate to the inner shaft 112 and can rotatably couple to theouter hub 132. FIGS. 5A-5C show different views of the inner hub 134 ofFIG. 2. While the inner hub 134 can have a variety of configurations, inthe illustrated embodiment the inner hub 134 is a generally cylindricalmember having a proximal end 134 a and a distal end 134 b. The inner hub134 can have a larger diameter portion on its proximal end 134 a and asmaller diameter cylindrical portion on its distal end 134 b so that itsproximal end 134 a can mate to the shaver hand piece 300 and its distalend 134 b can seat in a portion of the outer hub 132. The smallerdiameter portion can taper distally and can terminate at a pointeddistal tip 144. The distal end 134 b of the inner hub 134 can have amating feature 142 for mating with the inner shaft 112. While variousmating features can be used, in one embodiment the mating feature can bein the form of a circular slot that extends from the distal end 134 b ofthe hub 134 to an interior portion of the hub 134, as shown in FIGS.5A-5B. This mating feature 142 can be configured to receive a proximalend 112 a of the inner shaft 112, as will be described in more detail.As shown in FIG. 5C, the proximal end 134 a of the inner hub 134 caninclude a driver mating feature 148 for mating with a driver disposed inthe shaver hand piece 300 such that engagement of the driver causesrotation of the inner hub 134. In the illustrated embodiment, the drivermating feature 148 is in the form of a rectangular socket, however anyform of mating feature known in the art can be used.

The inner and outer hubs 134, 132 can be mated, as shown in FIGS. 6A and6B. In the illustrated embodiment, the distal end 134 b of the inner hub134 is inserted into the lumen 138 in the proximal end 132 a of theouter hub 132, and it can be secured by a press-fit. A person skilled inthe art will appreciate that the inner hub 134 can be secured to theouter hub 132 in a variety of other ways. In a preferred embodiment, theexit port 136 is unobstructed by other components, such as inner hub134, so that tissue and/or fluid can flow through the exit port 136. Forexample, in the illustrated embodiment the distal end 134 b of the innerhub 134 has a pointed distal tip 144 that terminates proximal to theexit port 136 so that tissue and fluid can readily flow through the exitport 136 and out of the device.

The cutting assembly 100, and in particular the inner and outer shafts112, 110 for cutting and transferring tissue and/or fluid from asurgical site, can also have a variety of configurations. FIGS. 7A and7B show the shafts in greater detail. In general, the inner and outershafts 112, 110 are elongate members having proximal ends 112 a, 110 a,distal ends 112 b, 110 b, and inner lumen 117 a, 117 b extendingtherethrough. Both shafts can include features, such as a plurality offriction elements 116, configured to fixedly secure the shaft within thehub assembly 130 using a press-fit. Various other mating techniquesknown in the art can be used to secure the shafts 110, 112 within thehub assembly 130, such as welding, adhesives, a mechanical engagement,or any other technique. The inner shaft 112 can be configured to rigidlyand non-rotatably mate to the inner hub 134 and can optionally beintegrally formed as a single component such that the inner shaft 112and the inner hub 134 are configured to move together as a unit.Similarly, the outer shaft 110 can be configured to rigidly andnon-rotatably mate to the outer hub 132 and can be integrally formed asa single component. In the illustrated embodiment, the inner shaft 112has a length that is greater than a length of the outer shaft 110, andthe inner shaft 112 has an outer diameter that is less than an innerdiameter of the outer shaft 110 so that it can rotate within the outershaft. The inner shaft 112 can further include ports 118 fortransferring tissue and fluid from the inner shaft 112 to the exit port136 disposed in the outer hub 132. The ports 118 are preferablypositioned at a location proximal to the proximal end 110 a of the outershaft 110, when the device is assembled, so that the outer shaft 110does not block fluid flow through the ports 118.

As further shown, the distal ends 112 b, 110 b of the inner and outershafts 112, 110 can also be configured to mate with an inner cuttingmember 122 and an outer cutting member 124, respectively. While thecutting members 122, 124 can have a variety of configurations, they arepreferably configured to excise adjacent tissue from a surgical site. Inthe illustrated embodiment, the cutting members 122, 124 have asubstantially cylindrical shape and include elliptical shaped openings126, 128 that extend through an outer sidewall. The openings 126, 128can have serrated teeth 129 a, 129 b on their circumference for cuttingtissue.

The components of the arthroscopic shaver of FIG. 1 can be assembledduring the manufacturing process or by a user. For example, the innershaft 112 can be mated with the inner hub 134 and the outer shaft 110can be mated with the outer hub 132, as shown in FIGS. 8 and 9,respectively. The distal end 112 b of the inner shaft 112 can beinserted into the proximal end 132 a of the outer hub 132 and throughthe outer shaft 110 until the components are secured by a press-fit, asillustrated in FIG. 10. In the alternative, the shafts 110, 112 and hubs132, 134 can be integrally formed during the manufacturing process. Inboth embodiments, the outer and inner hubs 132, 134 can be mated to thedistal end 300 a of the shaver hand piece 300 by a press-fit or usingother mating techniques, e.g. using threads, or other mechanicaltechniques. In addition, the driver mating feature 148 on the proximalend 132 a of the inner hub 134 can mate to a driver disposed in theshaver hand piece 300 so that engagement of the driver causes rotationof the inner hub 134. In particular, a shaft of the driver can be keyedto extend into and engage the mating feature 148 so that the driver canthereby effect rotation of the inner hub 134 and inner shaft 112. Aftera procedure is complete, the cutting assembly 100 can be disengaged fromthe hand piece 300 and disposed of, while the hand piece 300 can becleaned and reused. A person skilled in the art will appreciate that thecomponents of the tissue shaver can be assembled in numerous ways andusing a variety of securing mechanisms.

In use, the cutting assembly 100 of the tissue shaver 20 can be insertedinto an incision made in a patient. Optionally, the depth of the cuttingassembly 100 within the incision can be monitored using fluoroscopy,X-ray, or other visualization techniques known in the art. After thecutting assembly 100 is positioned at the desired depth, suction can beapplied through exit port 136. Tissue adjacent to the outer cuttingmember 124 is drawn through the openings 128, 126, respectively. Theactuators 310 on the shaver hand piece 300 can be depressed or otherwiseactivated, which causes the inner shaft 112 to rotate relative to theouter shaft 100. Because the shafts are non-rotatably coupled to thecutting members 122, 124, inner cutting member 122 rotates relative tothe outer cutting member 110 and the tissue trapped in the inner cuttingmember 122 is cut by the serrated teeth 129 a, 129 b. The appliedsuction causes the cut tissue and/or fluid to flow through the lumen 117b in the inner shaft 112 and out through exit port 136 formed in theouter hub 132. The cut tissue and/or fluid can be collected in asuitable waste collection container. This process can be repeated untilthe desired amount of tissue is excised from the surgical site. Afterthe procedure is complete, the cutting assembly 100 can be disengagedfrom the hand piece 300 and disposed of, while the hand piece 300 can becleaned and reused.

Components are also provided for retrofitting existing shaver handpieces that have an inner lumen for removing fluid and tissue from thedevice. For example, in one embodiment a tube can be inserted in theinner lumen of a hand piece and can extend between proximal and distalends of the hand piece. A distal end of the tube can be mated with aproximal end of the cutting assembly, such as a proximal end of an innershaft, and a proximal end of the tube can be coupled to a wastecollection container. Preferably, the cutting assembly and the tube havea fluid-tight connection that prevents tissue and fluid from directlycontacting the inner lumen of the hand piece. As shown in FIG. 11, inanother embodiment a tissue shaver 20 can include a cutting assembly(not shown), a connector 200, and a hand piece 400. The connector 200can connect a cutting assembly to the hand piece 400 and can preventtissue and fluid from entering the exit port in the shaver hand piece400. More specifically, one end of the connector 200 can mate to acutting assembly and the other end can mate to a hand piece 400. Theconnector 200 can divert tissue and/or fluid away from the shaver handpiece 400 and thereby minimize contact between the biological materialand the shaver hand piece 400. In both of the embodiments, tissue andbodily fluid is prevented from directly contacting a shaver hand piece,making cleaning and sterilization of the hand piece simpler and moreeffective.

FIGS. 12A-12C illustrate the connector 200 of FIG. 11 in greater detail.The connector 200 can mate to a cutting assembly and to a shaver handpiece 400, and can divert tissue away from the hand piece 400. In theillustrated embodiment, the connector 200 is a substantially cylindricalcomponent that includes tubular-shaped outer and inner hubs 232, 234.The outer and inner hubs 232, 234 operably connect the cutting assemblyto the shaver hand piece 400 and prevent tissue from contacting theshaver hand piece 400. The outer hub 232 further includes an exit port236 for diverting tissue from entering the hand piece 400. As shown inFIG. 12A, the outer hub 232 has a lumen 244 that extends between theproximal and distal ends 232 a, 232 b. The exit port 236 extends betweenthe lumen 244 and an outer sidewall of the outer hub 232. The inner hub234 blocks the proximal end of the lumen in the outer hub 232, such thatfluid is forced to flow through the exit port 236 and is prevented fromflowing into the hand piece (not shown). The position of the exit port236 can vary, but it is preferably located distal to the proximal end232 a of the outer hub 232, and distal to the distal end 234 b of theinner hub 234 when the hubs are assembled so that the inner hub 234 doesnot obstruct the exit port 236. A person skilled in the art willappreciate that the outer and inner hubs can be formed from a variety ofdifferent materials and can have a variety of configurations.

Because the connector 200 is an intermediary component positionedbetween the shaver hand piece 400 and the cutting assembly, the driverdisposed in the shaver hand piece 400 will not directly mate with thecutting assembly. Instead, the outer and inner hubs 232, 234 areconfigured to transfer a drive force between the hand piece 400 and thecutting assembly such that actuation of the driver disposed in the handpiece 400 causes the cutting assembly to sever tissue. As shown in FIGS.12B and 12C, the inner hub 232 can include a driver mating feature 248at a proximal end for mating to a driver disposed in the shaver handpiece 400. The inner hub 234 can further include a protrusion 240, shownin FIG. 13, at a distal end 234 b for mating directly to a portion of acutting assembly, such as a shaft. Alternatively, an intermediatecomponent (not shown) can join the inner hub 234 to the cutting assemblysuch that rotation of the inner hub 234 causes rotation of the cuttingassembly. FIGS. 12A-14 also show the outer hub 232, which has two matingfeatures 242 that can mate to corresponding features on the shaver handpiece 400. In the illustrated embodiment, the hand piece 400 can beguided toward the proximal end 230 a of the hub 230, and a distalportion of the hand piece 400 can seat in slot 247 a. The hand piece 400can further include protrusions that correspond to mating features 242so that the hand piece 400 can be twist-locked and secured to theconnector 200. FIG. 13 is an exploded view of the connector 200 thatshows the components in more detail. A person skilled in the art willappreciate that the connector can have a variety of configurations andcan include a variety of mating features configured to join theconnector with a cutting assembly and a shaver hand piece.

As shown in FIG. 14, the outer hub 232 can include mating elements 238on its distal end 232 b for mating to a cutting assembly. In theillustrated embodiment, the mating elements 238 are substantiallyL-shaped depressions formed in an inner sidewall of the outer hub 232.Corresponding protrusions on the cutting assembly can engage the matingelements 238 and the cutting assembly can be secured to the outer hub232 using a twist-lock. A portion of the cutting assembly can also beseated in slot 247 b formed in the outer hub 232 to allow rotation ofthe cutting assembly relative to the outer hub 232, and thus theconnector 200, as will be discussed below. A person skilled in the artwill appreciate that the cutting assembly can be secured to theconnector by various other means known in the art.

FIG. 14 also shows a cross-section of the inner hub 234 mated to theouter hub 232 by a press-fit. The inner hub 234 can be mated to theouter hub 232 by various other mating techniques known in the art, suchas welding, adhesives, a mechanical engagement. In the illustratedembodiment, the inner hub 234 is positioned so that the exit port 236 isunobstructed by the inner hub 234. Preferably, when the cutting assemblyis attached to the outer hub 232 there is space in the inner lumen 244of the outer hub 232 for tissue and/or fluid to flow through the innerlumen 244 and out through the exit port 236. In addition, the protrusion240 of the inner hub 234 preferably terminates at a location proximal tothe exit port 236 to allow tissue and fluid to readily flow through theexit port 236. A person skilled in the art will appreciate that theangle of the exit port 236 relative to the lumen 244 can vary, e.g. theexit port 236 can extend perpendicular to the lumen 244 or it can extendat an acute or obtuse angle.

The arthroscopic shaver of FIG. 11 functions similar to the embodimentshown in FIG. 1. In use, the cutting assembly (not shown) of the tissueshaver 20 can be inserted into an incision made in a patient. Theposition of the cutting assembly can be monitored using a variety ofvisualization techniques known in the art, such as X-ray imaging.Suction can be applied to the cutting assembly at exit port 236 disposedin the connector 200. The applied suction draws tissue adjacent to thecutting members through their respective openings and into an innerlumen. The actuators 410 on the shaver hand piece 400 can be depressed,causing the cutting assembly to sever the tissue disposed in the innerlumen of the cutting assembly, such as by the rotation of inner andouter cutting elements. Actuation of the driver causes the inner hub 234to rotate relative to the outer hub 232. Because the inner hub 234 has aprotrusion 240 that is operably coupled to the inner shaft of thecutting assembly, rotation of the inner hub 234 causes the inner shaftto rotate relative to the outer hub and an outer shaft, thereby severingtissue. The cut tissue and/or fluid to flows through the lumen of thecutting assembly and out through the exit port 236 formed in the outerhub 232 of the connector 200. Rather than allowing tissue and/or fluidto flow through an inner lumen in the shaver hand piece 400, theconnector 200 diverts this material away from the shaver hand piece 400and out through exit port 236. Because tissue and fluid is preventedfrom entering the hand piece 400, the hand piece 400 is easier to cleanand has a decreased risk of cross-contaminating a surgical site. The cuttissue and/or fluid can be collected in a suitable waste collectioncontainer and the process can be repeated until the desired amount oftissue is excised from the surgical site. Similar to the embodimentshown in FIG. 1, after the procedure is complete, the cutting assemblycan be removed from the connector 200 and disposed of, and the connector200 can be removed from the shaver hand piece 400. The shaver hand piece400 and/or the connector 200 can be cleaned and reused, if desired.

As will be appreciated by a person skilled in the art, the tissueshavers provided can be used to remove tissue from various regions inthe body, including by way of non-limiting example, shoulder, hip,wrist, knee, and spine.

One skilled in the art will appreciate further features and advantagesof the invention based on the above-described embodiments. Accordingly,the invention is not to be limited by what has been particularly shownand described, except as indicated by the appended claims. Allpublications and references cited herein are expressly incorporatedherein by reference in their entirety.

What is claimed is:
 1. An arthroscopic tissue shaver device, comprising:a handle having a driver and an internal passageway, the internalpassageway extending between proximal and distal ends of the handle andbeing configured for receiving fluid therethrough; a shaft assemblyhaving an outer shaft and an inner shaft, the inner and outer shaftseach having at least one distal opening, and the inner shaft having atissue cutting distal tip positioned adjacent to the at least one distalopening of the outer shaft for cutting tissue extending through theopening; and a coupler having an inner hub and an outer hub, the couplerfor transferring a drive force from the driver to the inner shaft, thecoupler having each of a shaft mating feature for releasably mating witha proximal end of the outer shaft of the shaft assembly, an exit portfor diverting fluid received from the inner shaft out of the device, adistally extending protrusion disposed at a distal end of the inner hubthat terminates at a distal-facing surface of the inner hub, thedistal-facing surface being substantially perpendicular to a couplerlongitudinal axis that extends through a length of the coupler, thecoupler longitudinal axis extending in a direction that is substantiallyparallel to or aligned with a shaft longitudinal axis that extendsthrough a length of at least one of the inner shaft and the outer shaft,the distally extending protrusion being adapted to releasably mate witha proximal end of the inner shaft by positioning the proximal end of theinner shaft around the protrusion, and a driver mating featureconfigured to releasably mate with a corresponding mating feature on thedriver, wherein the coupler is configured to retrofit the handle toprevent fluid from flowing out of the inner lumen of the inner shaft andinto the internal passageway in the handle.
 2. The device of claim 1,wherein the exit port is configured to allow fluid and tissue to passtherethrough.
 3. The device of claim 1, wherein the exit port has acentral axis that extends substantially transverse to a central axis ofthe inner and outer shafts.
 4. The device of claim 1, wherein the outershaft is configured to press-fit with the coupler.
 5. The device ofclaim 1, wherein the coupler has an inner lumen formed therein having afirst end in communication with the inner lumen of the inner shaft, anda second end in communication with the exit port.
 6. The device of claim1, wherein the internal passageway of the handle extends along a centrallongitudinal axis of the handle between the proximal and distal ends. 7.The device of claim 1, wherein the inner shaft includes at least oneport configured to allow fluid and tissue to pass therethrough.
 8. Thedevice of claim 7, wherein the at least one port directs fluid throughthe exit port of the coupler.
 9. The device of claim 1, wherein thedistal end of the inner hub further comprises a recess formed betweenthe distal-facing surface and the protrusion to receive a portion of theinner shaft therein.
 10. A connector for retrofitting a tissue shaverthat directs fluid through a proximal end of a handle, the connectorcomprising: a housing having an inner hub and an outer hub, the innerhub having a proximal end that includes a drive feature for coupling toa driver disposed in a handle of a tissue shaver to which the connectoris coupled, and the outer hub having each of a lumen formed in the outerhub for receiving fluid from an inner shaft of a shaft assembly of atissue shaver to which the connector is coupled, a first mating featureconfigured to releasably mate with a corresponding mating feature on anouter shaft of a shaft assembly of a tissue shaver to which theconnector is coupled, and an exit port for directing fluid away from ahandle of a tissue shaver to which the connector is coupled, wherein theinner hub is configured for releasably mating with a proximal end of aninner shaft of a shaft assembly of a tissue shaver to which theconnector is coupled, wherein an exterior surface of a proximal end ofthe outer hub has a reduced diameter portion, the reduced diameterportion being configured to allow a tapered distal end of the inner hubto pass through the proximal end, the reduced diameter portion having aninner wall configured to abut an outer wall of the inner hub at a firstlocation along a length of the inner hub to secure the inner hub to theouter hub, the inner hub having a substantially uniform diameter fromthe first location to the proximal end of the inner hub, wherein theinner hub is configured to rotate relative to the outer hub to transfera rotating drive force from a driver of a tissue shaver to which theconnector is coupled to an inner shaft of that same tissue shaver, andwherein the inner wall is configured to abut the tapered distal end ofthe inner hub at a second location along the length of the inner hub tosecure the inner hub to the outer hub, a distance between the secondlocation and a central longitudinal axis of the outer hub being smallerthan a distance between the first location and the central longitudinalaxis of the outer hub.
 11. The connector of claim 10, wherein theproximal end of the outer hub has a second mating feature configured topress-fit with a handle of a tissue shaver to which the connector iscoupled.
 12. The connector of claim 11, wherein the first and secondmating features formed on the outer hub comprise longitudinal slotsextending in a proximal to distal direction.
 13. The connector of claim10, wherein the proximal end of the inner hub is sealed to preventtissue and fluid flowing through the lumen in the housing fromcontacting a handle of a tissue shaver to which the connector iscoupled.
 14. The connector of claim 10, wherein the lumen is incommunication with the exit port for directing fluid through the outerhub and out of the exit port.
 15. The connector of claim 10, wherein theinner wall abuts the outer wall of the inner hub at the first locationand the tapered distal end of the inner hub at the second locationsimultaneously.
 16. A method of assembling a tissue shaver, comprising:detaching a first inner shaft of a shaft assembly of a tissue shaverfrom an inner rotatable hub associated with a coupler of the tissueshaver; coupling a second inner shaft of the shaft assembly to the innerrotatable hub, the second inner shaft taking the place of the detachedfirst inner shaft; and coupling a driver of a handle assembly of thetissue shaver to a proximal end of the inner rotatable hub such that adrive force from the driver can be transferred from the driver to theinner hub, and thus to the second inner shaft; wherein the couplerincludes an exit port formed therein for diverting fluid out of thecoupler, and wherein coupling the second inner shaft to the innerrotatable hub includes positioning the second inner shaft over aprotrusion that extends to a distal-most point of the inner rotatablehub and engaging the protrusion with the second inner shaft to couplethe second inner shaft to the inner rotatable hub.
 17. The method ofclaim 16, wherein the handle assembly includes an inner passagewayextending therethrough between proximal and distal ends and the step ofcoupling the second inner shaft of the shaft assembly to the innerrotatable hub provides a path for fluid to travel through the secondinner shaft and out of the exit port.
 18. The method of claim 16,wherein the coupler is a separate component from the tissue shaver suchthat prior to attaching the coupler to the handle assembly of the tissueshaver, no fluid path exists between the second inner shaft and tissueshaver to allow fluid to be evacuated from the second inner shaft. 19.The method of claim 16, wherein coupling the second inner shaft to theinner rotatable hub further comprises sliding the second inner shaftover the protrusion proximally along the protrusion such that the secondinner shaft is received in a recess formed between a distal-facingsurface of the inner rotatable hub from which the protrusion extends andthe protrusion.